Ask the Nurse: Women's Health

Below are some commonly asked questions and answers regarding women’s health concerns. If you do not see an answer to your question here, feel free to contact the Women’s Health Clinic for more information. Click on a question below to read the answer.

What kinds of contraceptives are available?

Do I need emergency contraception (ECP/Morning After Pill)?

If you are not using any type of birth control and have had unprotected intercourse, you need emergency contraception. Further recommendations for specific concerns are addressed below. You may also visit The Emergency Contraception Website for additional questions and answers.

Emergency Contraceptive Pills (ECPs) are available without a prescription to anyone in the SHCC Pharmacy as well as external retail pharmacies. ECPs are available to students for $10 in the SHCC Pharmacy. If you use emergency contraception and do not have a period within 3 weeks after taking it, you need to take a pregnancy test.

If you are on birth control but feel you have used it incorrectly, please contact SHCC Pharmacy staff or the Women’s Health Clinic directly to discuss whether or not you need emergency contraception. Below is some information on troubleshooting birth control usage. Additional information may be found in the following questions and answers.

Changing pill brands – If you change from one brand of birth control pills to another without interruption, emergency contraception is not needed.

Changing hormonal method brands – If you change from one hormonal birth control method to another without interruption, emergency contraception is not needed.

Time of day – If you take your pills at different times of the day, emergency contraception is not needed.

Missed start date – If you miss starting your pack of pills at the appropriate time and have unprotected intercourse, use emergency contraception if you’ve missed your pills for 48 to 72 hours and you have not been taking your pills correctly and on schedule for 7 days.

Nuvaring issues – If your Nuvaring has been out for more than 3 hours and you have had unprotected intercourse, use emergency contraception. Start a new Nuvaring cycle and use back-up contraception for 7 days. Expect break-through bleeding.

I missed a pill. What should I do?

If you missed 1 pill, take it as soon as you remember to. If you are taking today’s pill and realize you missed yesterday’s pill, take both pills at the same time. You are still protected from pregnancy as long as you catch up your doses within 24 hours. In this case, you do not need emergency contraception. If taking a progestin only pill, you should use a back up method for the next 48 hours.

If you missed 2 pills in a row — including starting your pack 2 days late — you have lost protection against pregnancy. Use emergency contraception if you have had unprotected intercourse. Catch up on your missed pills by taking 2 today and 2 tomorrow. Continue taking the rest of the pack. Make sure to use back-up contraception, such as condoms, for 7 days. (It takes 7 days back on schedule to get your contraception back.) Expect break-through bleeding.

If you missed 3 pills in a row, you are going to bleed — just consider this your period placebo days. Start a new pack of pills right away. Make sure to use back-up contraception, such as condoms, for 7 days. Do not rely on the pill to protect you from pregnancy until you are back on it for 7 days! Use emergency contraception if:

You have unprotected sex during those 7 days.

You have unprotected sex after missing your pills for 48 to 72 hours and you have not been taking your pills correctly and on schedule for 7 days.

Am I protected from pregnancy during the placebo days of my birth control pill? OR Am I protected from pregnancy during the days off between my birth control ring?

I am having irregular bleeding. What does that mean?

If you are on a hormonal contraceptive method — such as the pill, ring, patch, Mirena or Implanon — it is most likely related to the hormones. If you are late taking a pill or change your schedule you may have bleeding. Keep a calendar of your bleeding days and contact us if it is unusually heavy or persists the next cycle.

If you are not on a hormonal contraceptive method, your cycle may be affected by stress, travel, exercise, dietary changes, weight gain or loss or illness. Chlamydia may also cause light bleeding; if you have not been screened and have had unprotected intercourse, chlamydia testing can be done with a urine sample by appointment.

What bleeding changes need to be evaluated by a health care provider? If you have repeated bleeding after intercourse, unusually heavy bleeding, unusually painful cramping with bleeding or irregular bleeding that persists the next cycle, please call to schedule an appointment.

I missed my period, but I am on the pill. What does this mean?

If you have been taking your pills correctly every day and you are not on any prescription medications which might interfere with pill effectiveness (rifampin, griseofulvin, certain seizure medications), you are not pregnant. Many of today’s low dose pills stimulate very little lining of the uterus to develop and, in some circumstances (stress, travel, diet change, exercise change), there is minimal to no bleeding. Keep taking your pills. If you miss a second period, you should take a pregnancy test just to be sure.

If you cannot tolerate not having a period, we can change your pill; however, many women see this as an added benefit and it is not unhealthy to not menstruate as long as you are on birth control.

I missed my period, but I am not on the pill. What does this mean?

If your cycles are mostly regular and you are not sexually active in any way that could potentially get you pregnant — the “pulling out” method included! — then it is probably related to stress, life style changes, dietary changes etc (see “Am I protected from pregnancy during the placebo days of my birth control pill? OR Am I protected from pregnancy during the days off between my birth control ring?”).

Keep a calendar of your menstruation pattern. If you miss 2 or 3 periods, call to make an appointment. We can check some basic lab studies to rule out thyroid or pituitary gland problems and we can also stimulate a period with hormones.

Many times nature takes it course and your cycles will return as your body rhythm returns. If there is no risk of pregnancy it is safe to wait and see if your cycles return in 2-3 months. If, on the other hand, you are sexually active in any way that could potentially get you pregnant, you should take a pregnancy test.

The most common reason for a missed period is pregnancy. Over-the-counter pregnancy tests are very accurate and can detect pregnancy right at the time of the missed period or about 14 days after possible conception. You may also call to schedule a pregnancy test with the Women’s Health Clinic.

I think I have a yeast infection. What should I do?

Yeast infections are very common and usual symptoms include vaginal itching/burning, redness of the skin around the vagina, discomfort during and after vaginal intercourse and increased discharge. If you have taken antibiotics recently you are at high risk of a secondary vaginal yeast infection.

You may use an over-the-counter yeast infection treatment. (We suggest the 3-day cream or suppositories.) If your symptoms do not improve in 1 week, make an appointment for an examination. If you find sores or bumps, also make an appointment for an examination. If you have had unprotected sex, you need to be tested for sexually transmitted diseases/infections (STDs/STIs).

I am worried I might have a sexually transmitted disease/infection (STD/STI). What should I look for and how can I get tested?

If you find any bumps or sores, call the Women’s Health Clinic or your medical team and make an appointment to be seen right away.

Genital Herpes, a common viral STI, can produce painful itchy blisters and sores. This diagnosis is best made with a culture of the sores. Treatment with an antiviral medication early in the course of infection reduces discomfort by several days.

Human Papilloma Virus (HPV) is the most common viral STI. Genital warts are raised, irregular bumps on the surface of the skin; these are not usually painful but can itch. We diagnose these by visual examination, and can treat them with a variety of methods.

Chlamydia is the most common bacterial STI on the UF campus. Most of the time it causes no symptoms, but it may cause irregular bleeding and spotting, urinary discomfort and a change in vaginal discharge. Women should consider screening for this every year as part of their annual exam.

Gonorrhea is less common, but can produce symptoms of discharge, cramps and irregular bleeding. Both Chlamydia and Gonorrhea can be tested for with a urine sample — no exam required.